Individual provider Active NPI

Dusty Lynn Broxterman, DPM

  • Podiatrist
  • Grand Island, NE
National Provider Identifier
1376126250
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
398 Issued in NE
Practice address
620 N Diers Ave Ste 100
Grand Island, NE 68803-4985
Phone
(308) 381-0404
NPI assigned
Apr 29, 2021
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 398 NE Primary

Addresses

Primary practice location

620 N Diers Ave Ste 100
Grand Island, NE 68803-4985

Mailing address

PO Box 5020
Grand Island, NE 68802-5020
Phone (308) 381-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710004402 NE Practitioner - Podiatry 5597200865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Clinic of Central Nebraska PCGroup PAC ID 2264435569, 4 clinicians

Practice addresses (Care Compare)

620 N Diers Ave
Suite 100
Grand Island, NE 68803-4985
Phone (308) 381-0404

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue75
Removal of skin lesions1-10
Removal of nail tissue690
Removal or shaving of skin growth225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Clinic of Central Nebraska PC Podiatrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

1423 7th St
Aurora, NE 68818
Phone (402) 694-3171

620 N Diers Ave
Ste 100
Grand Island, NE 68803
Phone (308) 381-0404

Interoperability endpoints

  • Direct secure messaging: dbroxterman358639@ahs.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1376126250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5020",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025020",
            "telephone_number": "308-381-0404",
            "fax_number": "308-381-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N DIERS AVE STE 100",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034985",
            "telephone_number": "308-381-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROXTERMAN",
        "first_name": "DUSTY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.